Sacred Sexuality Retreat for Couples

Name

First Name Last Name

E-mail

Phone Number

-
Area Code Phone Number

Birthday

Location

The following information is to help both of us decide if this retreat is a good fit for you. It will also help me develop a retreat specific to YOUR needs and goals. Please be as a thorough and thoughtful as you can with your answers.

All your answers are strictly confidential and will not be shared with ANYONE.

AND please do NOT share your answers with your partner until you have both already submitted this form.

What are your relationship/sexual goals?

What other types of programs and practices have you explored to improve your relationship and/or sexual practice?